Provider Demographics
NPI:1750102745
Name:COMMUNAL HEALTH MEDICAL GROUP PC
Entity type:Organization
Organization Name:COMMUNAL HEALTH MEDICAL GROUP PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:FARSHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:MALEKMEHR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-782-3255
Mailing Address - Street 1:20201 SHERMAN WAY STE 109
Mailing Address - Street 2:
Mailing Address - City:WINNETKA
Mailing Address - State:CA
Mailing Address - Zip Code:91306-3269
Mailing Address - Country:US
Mailing Address - Phone:818-782-3255
Mailing Address - Fax:
Practice Address - Street 1:20201 SHERMAN WAY STE 109
Practice Address - Street 2:
Practice Address - City:WINNETKA
Practice Address - State:CA
Practice Address - Zip Code:91306-3269
Practice Address - Country:US
Practice Address - Phone:818-960-4000
Practice Address - Fax:818-922-7019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-22
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care